Reproductive wrap-up

Today we’re talking reproductive health – from menstruation to menopause and beyond. And have we got the wrap-up for you! Whether you’re thinking about your future fertility, having issues falling pregnant, looking for the right contraception choice, or wanting some hormonal help…it’s important to get the right advice, information and support.

What’s on today’s agenda?

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Listening time: 2 mins

Female repro’: a quick lesson

It’s helpful to know what each part of the female reproductive system is called, so you can talk about these body parts with your doctor if needed.

Here we point out some of the important parts – and how they work together. It may seem simple at first glance, but what this system does is truly wondrous!

The ovaries – where it all begins. Sitting on each side of your uterus in the pelvis, the ovaries release an egg in the middle of your menstrual cycle.

The fallopian tubes – connect the ovaries to the uterus.

The uterus (also known as the womb) – where a baby grows if a woman is pregnant.

The cervix – the gatekeeper to the uterus. The cervix produces mucous which creates a ‘plug’ to protect the unborn baby. It dilates during labour before birth, to allow the baby to pass through.

The vagina – where the menstrual fluid flows through when you have your period, where a baby passes through when it’s being born. It’s also the passage for sexual intercourse.

There’s another important part of the female reproductive system that’s not in the picture above. It’s called the vulva. Many women don't know what the vulva is, or the difference between it and the vagina. So, we’re here to clear up the confusion!

While the vagina is on the inside of a woman’s body, the vulva is the general name given to outside parts of the female genitals. The vulva includes the inner and outer lips (labia), the clitoris, the urethral opening (where your urine, or wee, comes out) and the vaginal opening.

Quiz | Fertility facts

The roads to reproduction are varied. For some women, the path is straight and (relatively) stress-free. For many others, it’s filled with roadblocks and complicated twists and turns. Also, some women may choose to bypass the path of having children altogether.

Whichever route you’re travelling in life, it helps to understand the facts about fertility, so you can make informed decisions and plan as best you can for your journey ahead.

There are only six days in a woman’s menstrual cycle when pregnancy is possible.

The six days when pregnancy is possible are what’s known as a woman’s 'fertile window’. Exactly when these days occur in a menstrual cycle depends on how long the cycle is, and this can vary a lot among women.

The six days of the fertile window include the day of ovulation (when an egg is released from an ovary) and the five days beforehand. Having sex (intercourse) during these days gives you the best chance of getting pregnant.

Read more about the fertile window in the section below, 'Getting the timing right'.

When it comes to age and fertility, it is the combination of both partners' ages that determines the likelihood of pregnancy.

Many of us know that a woman’s age is the most important factor affecting her fertility, but a man’s age also plays a part in the odds of achieving a healthy pregnancy.

Research shows that men younger than 40 have a better chance of fathering a child than those older than 40, and this is likely due to sperm quality decreasing with age. The decline in a woman’s fertility starts to speed up from around the age of 35, with a decline in egg quality.

For couples trying to get pregnant where the woman is 35 or younger, their monthly chance of getting pregnant is about 20%, or one in five. By age 40, the chance of pregnancy is about 5% each month.

The male partner’s weight does not affect a couple's ability to have a baby.

For both men and women, being a healthy weight can increase the chance of pregnancy and having a healthy baby. Men who are overweight or obese have poorer sperm quality and are not as fertile as men of a healthy weight. For women, being overweight – or underweight – can impact hormone levels, the menstrual cycle and the quality of eggs.

Healthy eating, regular exercise and losing even just a few extra kilos can boost both male and female fertility.

If left untreated, STIs such as chlamydia and gonorrhoea can go on to cause reproductive complications such as pelvic inflammatory disease (PID), which can cause fallopian tube blockage that can lead to infertility.

These STIs can also affect male fertility if left untreated. They can harm sperm quality and cause damage to the male tubes. What’s more, chlamydia and gonorrhoea often have no symptoms – or the symptoms are mistaken for something else – and people may not even know they are infected and/or endangering others.

The good news is, these STIs are easily diagnosed and treated by your doctor, so it’s important to have routine STI screenings and always practise safer sex.

A woman’s caffeine intake may impact how long it takes to get pregnant.

The research is not entirely clear on this topic, but several studies have shown that women who consume large amounts of caffeine may take longer to become pregnant and may have a higher risk of miscarriage.

Caffeine can be found in varying amounts in coffee, black and green tea, energy drinks, chocolate and some soft drinks such as cola.

It is recommended that women limit their caffeine intake to 200mg per day (about two cups of coffee) if they are pregnant or trying to get pregnant.

Research has found that one particular position during sex can increase the chances of becoming pregnant.

There are a lot of myths about certain positions during sex boosting the chances of pregnancy success. Unfortunately, there is no firm research that favours one particular sexual position over another.

Many people believe that deeper penetration (for example, in the positions of male on top, or male from behind) means the sperm have a shorter distance to travel and a larger chance of success, but there is no evidence to support this.

IVF treatment can overcome age-related infertility.

Many people believe that IVF is a good back-up option for having children at a later age. However, this is not the case when it comes to couples using their own eggs and sperm. The technology of IVF cannot make up for the natural decrease in fertility that comes with age.

For couples having IVF, the chances of having a baby are higher if the woman is younger than 35 years of age and decreases significantly after 40 years of age. The chance of having a baby after one IVF cycle for women aged between 40 and 44 is only about 5%.

On the male side of the equation, the chance of having a baby with IVF is higher if the man is younger than 41 years of age.

If you have already had one baby, you can easily have another.

Even if a woman has already had one or two children and wants a second or third child, her age at that time is the most important factor in determining the chance of that happening.

So, if a woman is 37 when she has her first child and then tries for a second child when she is 40, the monthly chance of getting pregnant then is only 5%.

Sperm do all the hard work in the journey towards reaching the egg.

While sperm need to be strong swimmers in order to reach the end-goal of the egg, they are by no means acting alone in their mission.

In fact, a good portion of a sperm’s journey is helped along by the woman’s muscles in her uterus (womb), which naturally tense and relax to gently coax the sperm along the fallopian tubes towards the egg.

What teamwork!

Nice work!

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Parting advice

It’s important to remember that no matter how healthy you are, or how old you are, sometimes it can be difficult to get pregnant. If you have been trying to get pregnant for 12 months or more – or six months if you’re a woman older than 35 years – it’s time to talk to your doctor about what to do next.

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There are many ways to manage your fertility, but which one is right for you?

Join us for today's Facebook Live video, as Jo Roberts of Jean Hailes for Women's Health speaks to gynaecologist and Jean Hailes medical director Dr Elizabeth Farrell about different types of contraception. Learn about the choices available to you, and which one might best suit you, your age and life situation.

What you didn’t know about STIs

If you're sexually active, STIs (sexually transmissible infections) are something you need to know about. That's because STIs don't discriminate; anyone can catch one, and it can take just one experience of unsafe sex to do so.

What’s more, not all STIs announce their presence, which means you can't always tell if you – or your sexual partner – are carrying one.

Do you know that chlamydia, an increasingly common STI, can lead to infertility if untreated? Yet only one in five cases will show any symptoms. So most who have chlamydia are unaware they do until they are tested.

According to the Kirby Institute at the University of New South Wales, 75% of chlamydia cases occur in people under 30 years. However, rates of infection in women aged 40 years+ are climbing at an alarming speed, and have doubled in the past decade.

Getting the timing right

If you're trying to get pregnant, it helps to know at what time of the month you are most fertile.

Pregnancy is possible during the ‘fertile window’ of a woman’s menstrual cycle. This includes the five days leading up to ovulation (egg release), plus the day of ovulation.

Your chance of conceiving is greatest if you have sex during the two days leading up to ovulation, or on the day of ovulation.

Most women ovulate about 14 days before their period starts. To work out your day of ovulation, you need to know how many days there are in your menstrual cycle. Each woman is different and cycle lengths can vary a lot. To calculate your own cycle, count the number of days from the first day of your period to the day before your next period.

This chart shows the most fertile days for menstrual cycles of different lengths.

Preparing for pregnancy

If you’re planning a pregnancy, it’s a good idea to visit your doctor beforehand to give yourself and your baby the best chance for a healthy start.

Together with your doctor, you can talk about and take action on any general health issues – such as your weight or existing medical conditions – as well as your immunisation history and any lifestyle issues such as your diet, smoking and alcohol or drug use.

Your doctor can also make sure you are up to date with your health checks. Pre-pregnancy health checks include a cervical screening test, STI screening test, breast check, gynaecological assessment, dental check, mental health check and a review of any medicines you may be taking.

It's important to start taking folate before you get pregnant, to reduce the risk of the baby being born with neural tube defects such as spina bifida. Folate is one of the B vitamins and is best taken as a supplement (folic acid).

If you're planning a pregnancy, more information on pre-pregnancy vaccinations is available from the Royal Women’s Hospital website.

To learn more about the everyday factors that can increase your chance of becoming pregnant and having a healthy baby, try the Your Fertility healthy conception tool. If you have a male partner, they can use it too. Their health is just as important as yours.

Egg freezing

Perhaps you’ve given yourself every chance of being as fertile as possible, perhaps you’ve readied yourself for pregnancy, but life – or the timings of events – just hasn’t lined up.

For hopeful mums-to-be, egg freezing can be seen as a way to draw a line in the sands of time. But is it as simple as buying time? Is there a ‘right time’ to freeze your eggs? And how is it done?

Sensational beef & ginger stir-fry

Created by Jean Hailes naturopath Sandra Villella and Marley Spoon, this recipe has been designed with the female reproductive system in mind.

It's rich in iron – a nutrient that's particularly important for women who get periods, as blood loss can deplete your body’s iron stores.

It also has a low glycaemic index, which means it will give you a steady release of energy – especially helpful for women with polycystic ovary syndrome (PCOS) and comes with an extra kick of anti-inflammatory ingredients.

Contraception choices: know all your options

There's a contraceptive option that you may not know a lot about. It is convenient, safe, reliable, reversible, cost-effective and, most importantly, highly effective at preventing pregnancy.

It's called long-acting reversible contraception, or LARC. Yet while almost 15% of women in places such as northern Europe who use contraception choose LARC, only 6.5% of women in Australia make the same contraception choice.

Perhaps it's time we expanded our knowledge of contraceptive options beyond just condoms and the Pill?

Contraception in seven different languages

Do you know someone seeking information on contraception in a language other than English?

The Health Translations team at the Centre for Culture, Ethnicity and Health has just released a translated contraception guide in seven different languages including Dinka, Farsi-Persian, Hazaragi, Malay, Nepali, Tagalog and Karen.

The guide details the different types of contraception available to women in Australia.

Menopause & the workplace

Menopause is a woman’s final menstrual period and is a normal change that marks the end of her reproductive life. For some women, menopause can be a tricky time of navigating this change, and the symptoms that may come with it. This can be especially so in the workplace.

Pelvic pain

Chronic pelvic pain is a common condition that affects around 15% of women worldwide. It can have many different causes, such as endometriosis, pelvic inflammatory disease, irritable bowel syndrome, and more. Learn more about pelvic pain, and about our new Persistent Pelvic Pain Service now operating at the Jean Hailes Medical Centre in East Melbourne.

My period - what’s normal?

The vaginal microbiome & fertility

Research is turning to the microbiome (the bacteria and other micro-organisms) in the female reproductive system – and the effect it can have on a woman's fertility, as well as, potentially, IVF treatment.

Emotional support for difficult times

The Pink Elephants Support Network have created a suite of resources to support women navigating a miscarriage or infertility journey. Written by real women who have experienced early pregnancy loss or fertility issues, they provide empathy, validation and connection.

‘The vulva’ booklet

To help get you talking about this important area of health, we made an information booklet all about the vulva. Find out what’s normal when it comes to vulval health, what causes irritation, how it can be managed and handy health tips to keep in mind.

Your Fertility website

This website provides current information about what you can do to improve your chances of having children when the time is right for you. It's based on the most up-to-date scientific research and prepared by experts in the field.

Hormonal health: clues made clear

Hormones can be a complex area of women's health, but certain changes to your vagina and vulva can give you some insight. So, what are the clues that these body parts are giving you, and what mysteries can they explain?